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Obamacare 2019 Rates for Jackson County


Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Jackson County, Wisconsin.

The health insurance rates listed below are for calendar year 2019.

Obamacare Providers, Plans and 2019 Rates for Jackson County, Wisconsin

Below, you’ll find a summary of the 34 plans for Jackson County and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.

For detailed information on available subsidies to make your coverage affordable, you must take one of the following actions:

  • Contact a licensed health insurance agent
  • Complete an application at HealthCare.gov
  • Contact the provider directly

The table below shows premiums for the following profiles at various ages:

  • Individuals
  • Couples
  • Couples with 1, 2, or 3 children
  • Individuals with 1, 2, or 3 children
  • A child alone

Each plan links to the insurance provider's website. You can find the following:

  • Summary of plan benefits and costs
  • Plan brochure
  • Provider Directory where you can find out which doctors and hospitals in the Black River Falls, WI area accept this insurance coverage as within the plan's network.

2019 Obamacare Rates, Providers, and Plans for Jackson County

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Unity Health Plans Insurance Corporation

Local: 1-608-644-3430 | Toll Free: 1-800-362-3310 | TTY: 1-800-877-8973

Gold

Plan: (HMO) Gundersen Health System (R) Gold Maintenance - Copay $40/$90 with Dental

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $1,500 | Family: $3,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$417.58
$473.95
$533.67
$745.80
$1,133.31
$835.16
$947.90
$1,067.34
$1,491.60
$2,266.62
$1,154.61
$1,267.35
$1,386.79
$1,811.05
$1,474.06
$1,586.80
$1,706.24
$2,130.50
$1,793.51
$1,906.25
$2,025.69
$2,449.95
$737.03
$793.40
$853.12
$1,065.25
$1,056.48
$1,112.85
$1,172.57
$1,384.70
$1,375.93
$1,432.30
$1,492.02
$1,704.15
$381.25

Silver

Plan: (HMO) Gundersen Health System (R) Silver 5000 - Copay $50/$100 with Dental

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $5,000 | Family: $10,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$493.85
$560.51
$631.13
$882.00
$1,340.29
$987.70
$1,121.02
$1,262.26
$1,764.00
$2,680.58
$1,365.49
$1,498.81
$1,640.05
$2,141.79
$1,743.28
$1,876.60
$2,017.84
$2,519.58
$2,121.07
$2,254.39
$2,395.63
$2,897.37
$871.64
$938.30
$1,008.92
$1,259.79
$1,249.43
$1,316.09
$1,386.71
$1,637.58
$1,627.22
$1,693.88
$1,764.50
$2,015.37
$450.88

Silver

Plan: (HMO) Gundersen Health System (R) Silver 7900 - Copay $80/$160 with Dental

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$477.76
$542.25
$610.57
$853.27
$1,296.63
$955.52
$1,084.50
$1,221.14
$1,706.54
$2,593.26
$1,321.00
$1,449.98
$1,586.62
$2,072.02
$1,686.48
$1,815.46
$1,952.10
$2,437.50
$2,051.96
$2,180.94
$2,317.58
$2,802.98
$843.24
$907.73
$976.05
$1,218.75
$1,208.72
$1,273.21
$1,341.53
$1,584.23
$1,574.20
$1,638.69
$1,707.01
$1,949.71
$436.19

Gold

Plan: (HMO) Gundersen Health System (R) Gold 2000 - Copay $30/$70 with Dental

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $2,000 | Family: $4,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$407.49
$462.49
$520.76
$727.76
$1,105.90
$814.98
$924.98
$1,041.52
$1,455.52
$2,211.80
$1,126.70
$1,236.70
$1,353.24
$1,767.24
$1,438.42
$1,548.42
$1,664.96
$2,078.96
$1,750.14
$1,860.14
$1,976.68
$2,390.68
$719.21
$774.21
$832.48
$1,039.48
$1,030.93
$1,085.93
$1,144.20
$1,351.20
$1,342.65
$1,397.65
$1,455.92
$1,662.92
$372.03

Silver

Plan: (HMO) Gundersen Health System (R) Silver 4000 - Copay $45/$90 with Dental

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $4,000 | Family: $8,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$499.33
$566.73
$638.14
$891.79
$1,355.17
$998.66
$1,133.46
$1,276.28
$1,783.58
$2,710.34
$1,380.64
$1,515.44
$1,658.26
$2,165.56
$1,762.62
$1,897.42
$2,040.24
$2,547.54
$2,144.60
$2,279.40
$2,422.22
$2,929.52
$881.31
$948.71
$1,020.12
$1,273.77
$1,263.29
$1,330.69
$1,402.10
$1,655.75
$1,645.27
$1,712.67
$1,784.08
$2,037.73
$455.88

Expanded Bronze

Plan: (HMO) Gundersen Health System (R) Bronze 7500 - Copay $80/$160 with Dental

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $7,500 | Family: $15,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$309.58
$351.37
$395.63
$552.90
$840.18
$619.16
$702.74
$791.26
$1,105.80
$1,680.36
$855.98
$939.56
$1,028.08
$1,342.62
$1,092.80
$1,176.38
$1,264.90
$1,579.44
$1,329.62
$1,413.20
$1,501.72
$1,816.26
$546.40
$588.19
$632.45
$789.72
$783.22
$825.01
$869.27
$1,026.54
$1,020.04
$1,061.83
$1,106.09
$1,263.36
$282.64

Bronze

Plan: (HMO) Gundersen Health System (R) Bronze 7900 - Copay $50/$100 with Dental

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$301.78
$342.52
$385.67
$538.97
$819.02
$603.56
$685.04
$771.34
$1,077.94
$1,638.04
$834.42
$915.90
$1,002.20
$1,308.80
$1,065.28
$1,146.76
$1,233.06
$1,539.66
$1,296.14
$1,377.62
$1,463.92
$1,770.52
$532.64
$573.38
$616.53
$769.83
$763.50
$804.24
$847.39
$1,000.69
$994.36
$1,035.10
$1,078.25
$1,231.55
$275.52

Silver

Plan: (HMO) Gundersen Health System (R) Silver 5000 - Copay $50/$100

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $5,000 | Family: $10,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$470.49
$534.00
$601.28
$840.29
$1,276.90
$940.98
$1,068.00
$1,202.56
$1,680.58
$2,553.80
$1,300.90
$1,427.92
$1,562.48
$2,040.50
$1,660.82
$1,787.84
$1,922.40
$2,400.42
$2,020.74
$2,147.76
$2,282.32
$2,760.34
$830.41
$893.92
$961.20
$1,200.21
$1,190.33
$1,253.84
$1,321.12
$1,560.13
$1,550.25
$1,613.76
$1,681.04
$1,920.05
$429.55

Silver

Plan: (HMO) Gundersen Health System (R) Silver 7900 - Copay $80/$160

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$455.16
$516.61
$581.69
$812.92
$1,235.30
$910.32
$1,033.22
$1,163.38
$1,625.84
$2,470.60
$1,258.52
$1,381.42
$1,511.58
$1,974.04
$1,606.72
$1,729.62
$1,859.78
$2,322.24
$1,954.92
$2,077.82
$2,207.98
$2,670.44
$803.36
$864.81
$929.89
$1,161.12
$1,151.56
$1,213.01
$1,278.09
$1,509.32
$1,499.76
$1,561.21
$1,626.29
$1,857.52
$415.56

Gold

Plan: (HMO) Gundersen Health System (R) Gold Maintenance - Copay $40/$90

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $1,500 | Family: $3,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$397.84
$451.54
$508.43
$710.52
$1,079.71
$795.68
$903.08
$1,016.86
$1,421.04
$2,159.42
$1,100.02
$1,207.42
$1,321.20
$1,725.38
$1,404.36
$1,511.76
$1,625.54
$2,029.72
$1,708.70
$1,816.10
$1,929.88
$2,334.06
$702.18
$755.88
$812.77
$1,014.86
$1,006.52
$1,060.22
$1,117.11
$1,319.20
$1,310.86
$1,364.56
$1,421.45
$1,623.54
$363.22

Gold

Plan: (HMO) Gundersen Health System (R) Gold 2000 - Copay $30/$70

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $2,000 | Family: $4,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$388.22
$440.62
$496.13
$693.34
$1,053.60
$776.44
$881.24
$992.26
$1,386.68
$2,107.20
$1,073.42
$1,178.22
$1,289.24
$1,683.66
$1,370.40
$1,475.20
$1,586.22
$1,980.64
$1,667.38
$1,772.18
$1,883.20
$2,277.62
$685.20
$737.60
$793.11
$990.32
$982.18
$1,034.58
$1,090.09
$1,287.30
$1,279.16
$1,331.56
$1,387.07
$1,584.28
$354.44

Silver

Plan: (HMO) Gundersen Health System (R) Silver 4000 - Copay $45/$90

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $4,000 | Family: $8,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$475.71
$539.93
$607.96
$849.62
$1,291.07
$951.42
$1,079.86
$1,215.92
$1,699.24
$2,582.14
$1,315.34
$1,443.78
$1,579.84
$2,063.16
$1,679.26
$1,807.70
$1,943.76
$2,427.08
$2,043.18
$2,171.62
$2,307.68
$2,791.00
$839.63
$903.85
$971.88
$1,213.54
$1,203.55
$1,267.77
$1,335.80
$1,577.46
$1,567.47
$1,631.69
$1,699.72
$1,941.38
$434.32

Expanded Bronze

Plan: (HMO) Gundersen Health System (R) Bronze 7500 - Copay $80/$160

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $7,500 | Family: $15,000
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$294.94
$334.75
$376.92
$526.75
$800.45
$589.88
$669.50
$753.84
$1,053.50
$1,600.90
$815.50
$895.12
$979.46
$1,279.12
$1,041.12
$1,120.74
$1,205.08
$1,504.74
$1,266.74
$1,346.36
$1,430.70
$1,730.36
$520.56
$560.37
$602.54
$752.37
$746.18
$785.99
$828.16
$977.99
$971.80
$1,011.61
$1,053.78
$1,203.61
$269.27

Bronze

Plan: (HMO) Gundersen Health System (R) Bronze 7900 - Copay $50/$100

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$287.51
$326.32
$367.43
$513.48
$780.29
$575.02
$652.64
$734.86
$1,026.96
$1,560.58
$794.96
$872.58
$954.80
$1,246.90
$1,014.90
$1,092.52
$1,174.74
$1,466.84
$1,234.84
$1,312.46
$1,394.68
$1,686.78
$507.45
$546.26
$587.37
$733.42
$727.39
$766.20
$807.31
$953.36
$947.33
$986.14
$1,027.25
$1,173.30
$262.49

Silver

Plan: (HMO) Gundersen Health System (R) Silver HSA 5250

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $5,250 | Family: $10,500
Out of Pocket Maximum per year: Individual: $5,250 | Family: $10,500

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$487.02
$552.76
$622.40
$869.80
$1,321.75
$974.04
$1,105.52
$1,244.80
$1,739.60
$2,643.50
$1,346.60
$1,478.08
$1,617.36
$2,112.16
$1,719.16
$1,850.64
$1,989.92
$2,484.72
$2,091.72
$2,223.20
$2,362.48
$2,857.28
$859.58
$925.32
$994.96
$1,242.36
$1,232.14
$1,297.88
$1,367.52
$1,614.92
$1,604.70
$1,670.44
$1,740.08
$1,987.48
$444.64

Gold

Plan: (HMO) Gundersen Health System (R) Gold HSA 2000

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $2,000 | Family: $4,000
Out of Pocket Maximum per year: Individual: $6,650 | Family: $13,300

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$406.60
$461.49
$519.63
$726.18
$1,103.51
$813.20
$922.98
$1,039.26
$1,452.36
$2,207.02
$1,124.25
$1,234.03
$1,350.31
$1,763.41
$1,435.30
$1,545.08
$1,661.36
$2,074.46
$1,746.35
$1,856.13
$1,972.41
$2,385.51
$717.65
$772.54
$830.68
$1,037.23
$1,028.70
$1,083.59
$1,141.73
$1,348.28
$1,339.75
$1,394.64
$1,452.78
$1,659.33
$371.22

Bronze

Plan: (HMO) Gundersen Health System (R) Bronze HSA 6750

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $6,750 | Family: $13,500
Out of Pocket Maximum per year: Individual: $6,750 | Family: $13,500

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$300.48
$341.04
$384.00
$536.64
$815.48
$600.96
$682.08
$768.00
$1,073.28
$1,630.96
$830.82
$911.94
$997.86
$1,303.14
$1,060.68
$1,141.80
$1,227.72
$1,533.00
$1,290.54
$1,371.66
$1,457.58
$1,762.86
$530.34
$570.90
$613.86
$766.50
$760.20
$800.76
$843.72
$996.36
$990.06
$1,030.62
$1,073.58
$1,226.22
$274.33

Catastrophic

Plan: (HMO) Gundersen Health System (R) Catastrophic

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$223.09
$253.20
$285.10
$398.43
$605.46
$446.18
$506.40
$570.20
$796.86
$1,210.92
$616.84
$677.06
$740.86
$967.52
$787.50
$847.72
$911.52
$1,138.18
$958.16
$1,018.38
$1,082.18
$1,308.84
$393.75
$423.86
$455.76
$569.09
$564.41
$594.52
$626.42
$739.75
$735.07
$765.18
$797.08
$910.41
$203.68

Gold

Plan: (HMO) Gundersen Health System (R) Gold HSA 3000

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Unity Health Plans Insurance Corporation)
Customer Service Phone: 1-800-362-3310

Deductible: Individual: $3,000 | Family: $6,000
Out of Pocket Maximum per year: Individual: $3,000 | Family: $6,000

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$410.93
$466.39
$525.16
$733.90
$1,115.24
$821.86
$932.78
$1,050.32
$1,467.80
$2,230.48
$1,136.21
$1,247.13
$1,364.67
$1,782.15
$1,450.56
$1,561.48
$1,679.02
$2,096.50
$1,764.91
$1,875.83
$1,993.37
$2,410.85
$725.28
$780.74
$839.51
$1,048.25
$1,039.63
$1,095.09
$1,153.86
$1,362.60
$1,353.98
$1,409.44
$1,468.21
$1,676.95
$375.17

ADVERTISEMENT

Security Health Plan of Wisconsin, Inc.

Local: 1-715-221-9258x19258 | Toll Free: 1-844-293-9624 | TTY: 1-877-727-2232

Bronze

Plan: (EPO) Select $6,000 HDHP

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $6,000 | Family: $12,000
Out of Pocket Maximum per year: Individual: $6,750 | Family: $13,500

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$358.28
$406.64
$457.87
$639.87
$972.34
$716.56
$813.28
$915.74
$1,279.74
$1,944.68
$990.64
$1,087.36
$1,189.82
$1,553.82
$1,264.72
$1,361.44
$1,463.90
$1,827.90
$1,538.80
$1,635.52
$1,737.98
$2,101.98
$632.36
$680.72
$731.95
$913.95
$906.44
$954.80
$1,006.03
$1,188.03
$1,180.52
$1,228.88
$1,280.11
$1,462.11
$327.10

Catastrophic

Plan: (EPO) Select Protection

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$233.60
$265.13
$298.53
$417.20
$633.97
$467.20
$530.26
$597.06
$834.40
$1,267.94
$645.90
$708.96
$775.76
$1,013.10
$824.60
$887.66
$954.46
$1,191.80
$1,003.30
$1,066.36
$1,133.16
$1,370.50
$412.30
$443.83
$477.23
$595.90
$591.00
$622.53
$655.93
$774.60
$769.70
$801.23
$834.63
$953.30
$213.27

Silver

Plan: (EPO) Select $4,800 - 30%

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $4,800 | Family: $9,600
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$478.30
$542.86
$611.26
$854.23
$1,298.08
$956.60
$1,085.72
$1,222.52
$1,708.46
$2,596.16
$1,322.49
$1,451.61
$1,588.41
$2,074.35
$1,688.38
$1,817.50
$1,954.30
$2,440.24
$2,054.27
$2,183.39
$2,320.19
$2,806.13
$844.19
$908.75
$977.15
$1,220.12
$1,210.08
$1,274.64
$1,343.04
$1,586.01
$1,575.97
$1,640.53
$1,708.93
$1,951.90
$436.68

Bronze

Plan: (EPO) Select $7,900

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$329.26
$373.70
$420.78
$588.04
$893.58
$658.52
$747.40
$841.56
$1,176.08
$1,787.16
$910.40
$999.28
$1,093.44
$1,427.96
$1,162.28
$1,251.16
$1,345.32
$1,679.84
$1,414.16
$1,503.04
$1,597.20
$1,931.72
$581.14
$625.58
$672.66
$839.92
$833.02
$877.46
$924.54
$1,091.80
$1,084.90
$1,129.34
$1,176.42
$1,343.68
$300.61

Silver

Plan: (EPO) Select $6,700 - 25%

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $6,700 | Family: $13,400
Out of Pocket Maximum per year: Individual: $7,800 | Family: $15,600

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$464.33
$527.00
$593.40
$829.27
$1,260.16
$928.66
$1,054.00
$1,186.80
$1,658.54
$2,520.32
$1,283.86
$1,409.20
$1,542.00
$2,013.74
$1,639.06
$1,764.40
$1,897.20
$2,368.94
$1,994.26
$2,119.60
$2,252.40
$2,724.14
$819.53
$882.20
$948.60
$1,184.47
$1,174.73
$1,237.40
$1,303.80
$1,539.67
$1,529.93
$1,592.60
$1,659.00
$1,894.87
$423.92

Gold

Plan: (EPO) Select $3,000 - 30%

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $3,000 | Family: $6,000
Out of Pocket Maximum per year: Individual: $5,500 | Family: $11,000

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$459.67
$521.71
$587.45
$820.95
$1,247.52
$919.34
$1,043.42
$1,174.90
$1,641.90
$2,495.04
$1,270.98
$1,395.06
$1,526.54
$1,993.54
$1,622.62
$1,746.70
$1,878.18
$2,345.18
$1,974.26
$2,098.34
$2,229.82
$2,696.82
$811.31
$873.35
$939.09
$1,172.59
$1,162.95
$1,224.99
$1,290.73
$1,524.23
$1,514.59
$1,576.63
$1,642.37
$1,875.87
$419.67

Silver

Plan: (EPO) Select $4,000 HDHP

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $4,000 | Family: $8,000
Out of Pocket Maximum per year: Individual: $6,750 | Family: $13,500

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$504.10
$572.14
$644.22
$900.30
$1,368.09
$1,008.20
$1,144.28
$1,288.44
$1,800.60
$2,736.18
$1,393.83
$1,529.91
$1,674.07
$2,186.23
$1,779.46
$1,915.54
$2,059.70
$2,571.86
$2,165.09
$2,301.17
$2,445.33
$2,957.49
$889.73
$957.77
$1,029.85
$1,285.93
$1,275.36
$1,343.40
$1,415.48
$1,671.56
$1,660.99
$1,729.03
$1,801.11
$2,057.19
$460.23

Bronze

Plan: (EPO) Select $6,750 HDHP

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $6,750 | Family: $13,500
Out of Pocket Maximum per year: Individual: $6,750 | Family: $13,500

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$356.85
$405.01
$456.04
$637.31
$968.46
$713.70
$810.02
$912.08
$1,274.62
$1,936.92
$986.68
$1,083.00
$1,185.06
$1,547.60
$1,259.66
$1,355.98
$1,458.04
$1,820.58
$1,532.64
$1,628.96
$1,731.02
$2,093.56
$629.83
$677.99
$729.02
$910.29
$902.81
$950.97
$1,002.00
$1,183.27
$1,175.79
$1,223.95
$1,274.98
$1,456.25
$325.79

Bronze

Plan: (EPO) Select $6,500

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Security Health Plan of Wisconsin, Inc.)
Customer Service Phone: 1-844-293-9624

Deductible: Individual: $6,500 | Family: $13,000
Out of Pocket Maximum per year: Individual: $7,850 | Family: $15,700

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$341.80
$387.93
$436.81
$610.44
$927.62
$683.60
$775.86
$873.62
$1,220.88
$1,855.24
$945.07
$1,037.33
$1,135.09
$1,482.35
$1,206.54
$1,298.80
$1,396.56
$1,743.82
$1,468.01
$1,560.27
$1,658.03
$2,005.29
$603.27
$649.40
$698.28
$871.91
$864.74
$910.87
$959.75
$1,133.38
$1,126.21
$1,172.34
$1,221.22
$1,394.85
$312.05

ADVERTISEMENT

Medica Health Plans of Wisconsin

Local: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-800-947-3529

Gold

Plan: (EPO) Engage by Medica Gold Copay

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Medica Health Plans of Wisconsin)
Customer Service Phone: 1-888-592-8211

Deductible: Individual: $750 | Family: $2,250
Out of Pocket Maximum per year: Individual: $6,500 | Family: $13,000

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$543.68
$617.07
$694.81
$971.00
$1,475.53
$1,087.36
$1,234.14
$1,389.62
$1,942.00
$2,951.06
$1,503.27
$1,650.05
$1,805.53
$2,357.91
$1,919.18
$2,065.96
$2,221.44
$2,773.82
$2,335.09
$2,481.87
$2,637.35
$3,189.73
$959.59
$1,032.98
$1,110.72
$1,386.91
$1,375.50
$1,448.89
$1,526.63
$1,802.82
$1,791.41
$1,864.80
$1,942.54
$2,218.73
$496.37

Silver

Plan: (EPO) Engage by Medica Silver Copay

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Medica Health Plans of Wisconsin)
Customer Service Phone: 1-888-592-8211

Deductible: Individual: $3,700 | Family: $11,100
Out of Pocket Maximum per year: Individual: $7,600 | Family: $15,200

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$605.77
$687.54
$774.16
$1,081.89
$1,644.03
$1,211.54
$1,375.08
$1,548.32
$2,163.78
$3,288.06
$1,674.95
$1,838.49
$2,011.73
$2,627.19
$2,138.36
$2,301.90
$2,475.14
$3,090.60
$2,601.77
$2,765.31
$2,938.55
$3,554.01
$1,069.18
$1,150.95
$1,237.57
$1,545.30
$1,532.59
$1,614.36
$1,700.98
$2,008.71
$1,996.00
$2,077.77
$2,164.39
$2,472.12
$553.06

Bronze

Plan: (EPO) Engage by Medica Bronze Copay

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Medica Health Plans of Wisconsin)
Customer Service Phone: 1-888-592-8211

Deductible: Individual: $6,850 | Family: $13,700
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$446.18
$506.41
$570.21
$796.87
$1,210.92
$892.36
$1,012.82
$1,140.42
$1,593.74
$2,421.84
$1,233.68
$1,354.14
$1,481.74
$1,935.06
$1,575.00
$1,695.46
$1,823.06
$2,276.38
$1,916.32
$2,036.78
$2,164.38
$2,617.70
$787.50
$847.73
$911.53
$1,138.19
$1,128.82
$1,189.05
$1,252.85
$1,479.51
$1,470.14
$1,530.37
$1,594.17
$1,820.83
$407.36

Bronze

Plan: (EPO) Engage by Medica Bronze HSA

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Medica Health Plans of Wisconsin)
Customer Service Phone: 1-888-592-8211

Deductible: Individual: $6,200 | Family: $12,400
Out of Pocket Maximum per year: Individual: $6,750 | Family: $13,500

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$477.23
$541.65
$609.89
$852.32
$1,295.19
$954.46
$1,083.30
$1,219.78
$1,704.64
$2,590.38
$1,319.54
$1,448.38
$1,584.86
$2,069.72
$1,684.62
$1,813.46
$1,949.94
$2,434.80
$2,049.70
$2,178.54
$2,315.02
$2,799.88
$842.31
$906.73
$974.97
$1,217.40
$1,207.39
$1,271.81
$1,340.05
$1,582.48
$1,572.47
$1,636.89
$1,705.13
$1,947.56
$435.71

Catastrophic

Plan: (EPO) Engage by Medica Catastrophic

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Medica Health Plans of Wisconsin)
Customer Service Phone: 1-888-592-8211

Deductible: Individual: $7,900 | Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$279.70
$317.45
$357.44
$499.53
$759.08
$559.40
$634.90
$714.88
$999.06
$1,518.16
$773.36
$848.86
$928.84
$1,213.02
$987.32
$1,062.82
$1,142.80
$1,426.98
$1,201.28
$1,276.78
$1,356.76
$1,640.94
$493.66
$531.41
$571.40
$713.49
$707.62
$745.37
$785.36
$927.45
$921.58
$959.33
$999.32
$1,141.41
$255.36

Expanded Bronze

Plan: (EPO) Engage by Medica Bronze HSA Plus

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for (Medica Health Plans of Wisconsin)
Customer Service Phone: 1-888-592-8211

Deductible: Individual: $3,100 | Family: $6,200
Out of Pocket Maximum per year: Individual: $6,750 | Family: $13,500

Monthly Premiums:

Age Individual
Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$496.50
$563.52
$634.52
$886.74
$1,347.48
$993.00
$1,127.04
$1,269.04
$1,773.48
$2,694.96
$1,372.82
$1,506.86
$1,648.86
$2,153.30
$1,752.64
$1,886.68
$2,028.68
$2,533.12
$2,132.46
$2,266.50
$2,408.50
$2,912.94
$876.32
$943.34
$1,014.34
$1,266.56
$1,256.14
$1,323.16
$1,394.16
$1,646.38
$1,635.96
$1,702.98
$1,773.98
$2,026.20
$453.30

‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Jackson County here.

Jackson County is in “Rating Area 6” of Wisconsin.

Currently, there are 34 plans offered in Rating Area 6.

Obamacare Rates and Providers for Past Years

2014 | 2015 | 2016| 2017 | 2018

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